Published online Jun 7, 2020. doi: 10.3748/wjg.v26.i21.2715
Peer-review started: January 1, 2020
First decision: February 19, 2020
Revised: March 27, 2020
Accepted: May 13, 2020
Article in press: May 13, 2020
Published online: June 7, 2020
The advent of lumen apposing metal stents (LAMS) has revolutionized the management of many complex gastroenterological conditions that previously required surgical or radiological interventions. These procedures have garnered popularity due to their minimally invasive nature, higher technical and clinical success rate and lower rate of adverse events. By virtue of their unique design, LAMS provide more efficient drainage, serve as conduit for endoscopic access, are associated with lower rates of leakage and are easy to be removed. Initially used for drainage of pancreatic fluid collections, the use of LAMS has been extended to gallbladder and biliary drainage, treatment of luminal strictures, creation of gastrointestinal fistulae, pancreaticobiliary drainage, improved access for surgically altered anatomy, and drainage of intra-abdominal and pelvic abscesses as well as post-surgical fluid collections. As new indications of endosonographic techniques and LAMS continue to evolve, this review summarizes the current role of LAMS in the management of these various complex conditions and also highlights clinical pearls to guide successful placement of LAMS.
Core tip: Lumen apposing metal stents have become widely adopted as a preferred modality in the treatment of pancreatic walled-off necrosis, with even broader applications for multiple alternative conditions. Current literature suggests that the use of these novel stents may significantly improve treatment response and provide a much needed minimally invasive therapeutic option to patients in need.